Objectives: To noninvasively assess global cerebral blood flow (CBF), oxygen extraction fraction (OEF) and cerebral metabolic rate of oxygen (CMRO<inf>2</inf>) in young adults with end-stage renal disease (ESRD). Methods: Thirty-six patients and 38 healthy volunteers were included and took part in MR examinations, blood and neuropsychological tests. CBF and OEF were measured by phase-contrast and T2-relaxation-under-spin-tagging MRI techniques, respectively. CMRO<inf>2</inf> was computed from CBF, OEF and hematocrit according to Fick’s principle. Correlations were performed between MR measurements, blood biochemistry measurements and neuropsychological test scores. Results: Compared with controls, ESRD patients had elevated CBF (72.9 ± 12.5 vs. 63.8 ± 8.5 ml min<sup>−1</sup> 100 g<sup>−1</sup>, P < 0.001), elevated OEF (47.2 ± 10.2 vs. 35.8 ± 5.4 %, P < 0.001), but unaffected CMRO<inf>2</inf> (199.5 ± 36.4 vs. 193.8 ± 28.6 μmol O<inf>2</inf> min<sup>−1</sup> 100 g<sup>−1</sup>, P = 0.879). Hematocrit negatively correlated with CBF (r = −0.640, P < 0.001) and OEF (r = −0.701, P < 0.001), but not with CMRO<inf>2</inf>. Altered neuropsychological test scores of ESRD patients were associated with OEF and CBF, but not with CMRO<inf>2</inf>. There were weak relationships between eGFR and hematocrit (r = 0.308, P = 0.068) or CBF (r = 0.318, P = 0.059). Conclusion: Our findings suggested that anaemic young adults with ESRD may afford higher CBF and OEF to maintain a normal CMRO<inf>2</inf>. Despite this compensatory process, however, cognitive function was still impaired and its severity was correlated with their CBF and OEF abnormality. Key Points: • Anaemic young adults with ESRD may afford higher CBF and OEF.• Anaemic young adults with ESRD maintain a normal CMRO<inf>2</inf>.• Cognitive function was still impaired in young ESRD adults.• The severity of cognitive dysfunction correlated with CBF and OEF changes.
- Cerebral blood flow
- Cerebral metabolic rate of oxygen
- End-stage renal disease
- Oxygen extract fraction
- Uremic encephalopathy
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging